Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. A person s mood and emotions can be altered drastically due to bipolar disorder, but they do not have more than one personality. Split personalities problem is more commonly seen in those with personality/dissociative disorders. 

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely  up,  elated, and energized behavior (known as manic episodes) to very sad,  down,  or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar I Disorder  defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
Bipolar II Disorder  defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
Cyclothymic Disorder (also called cyclothymia)  defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
Other Specified and Unspecified Bipolar and Related Disorders  defined by bipolar disorder symptoms that do not match the three categories listed above.
The disorder has two strong phases: 1) Bipolar Mania and 2) Depression.

Mania-

Mania is a state of heightened energy and euphoria - an elevation of mood. It is in direct contrast to depression. Mania can vary in severity from hypomania, where, in addition to mood and energy elevation, the person shows mild impairment of judgement and insight, to severe mania with delusions and a level of manic excitement that can be so exhausting that hospitalisation is required to control the episode.

The mood, energy and other related symptoms define both mania and hypomania, with psychotic features being an 'add on' component experienced by a sub-set of individuals. 

You have an intense sense of well-being, energy and optimism. It can be so strong that it affects your thinking and judgement. You may believe strange things about yourself, make bad decisions, and behave in embarrassing, harmful and - occasionally - dangerous ways.
 
Like depression, it can make it difficult or impossible to deal with day-to-day life. Mania can badly affect both your relationships and your work. When it isn't so extreme, it is called 'hypomania'.
 
If you become manic, you may notice that you are:

Emotional:

very happy and excited
irritated with other people who don't share your optimistic outlook
feeling more important than usual. 
Thinking:

full of new and exciting ideas
moving quickly from one idea to another
hearing voices that other people can't hear.
Physical:

full of energy
unable or unwilling to sleep
more interested in sex.  
Behaviour:

making plans that are grandiose and unrealistic
very active, moving around very quickly
behaving unusually
talking very quickly - other people may find it hard to understand what you are talking about
making odd decisions on the spur of the moment, sometimes with disastrous consequences
recklessly spending your money
over-familiar or recklessly critical with other people
less inhibited in general.
If you are in the middle of a manic episode for the first time, you may not realise that there is anything wrong   although your friends, family or colleagues will. You may even feel annoyed if someone tries to point this out to you. You increasingly lose touch with day-to-day issues   and with other people's feelings. 

Depression- 

The feeling of depression is something we all experience from time to time. It can even help us to recognise and deal with problems in our lives. In clinical depression or bipolar disorder, the feeling of depression is much worse. It goes on for longer and makes it difficult or impossible to deal with the normal things of life. If you become depressed, you will notice some of these changes:

Emotional:

feelings of unhappiness that don't go away
feeling that you want to burst into tears for no reason
losing interest in things
being unable to enjoy things
feeling restless and agitated
losing self-confidence
feeling useless, inadequate and hopeless
feeling more irritable than usual
thinking of suicide.  
Thinking:

can t think positively or hopefully
finding it hard to make even simple decisions
difficulty in concentrating. 
Physical:

losing appetite and weight
difficulty in getting to sleep
waking earlier than usual
feeling utterly tired
constipation
going off sex. 
Behaviour:

difficulty in starting or completing things   even everyday chores
crying a lot   or feeling like you want to cry, but not being able to
avoiding contact with other people.
Causes:

Biological Causes: Experts say that patients with bipolar disorder often show physical changes in their brains. Nobody is sure why the changes lead to the disorder.
Genetic Traits: Researchers are involved in finding out whether or not the causes of bipolar disorder arise out of genes and other hereditary factors. If you have a first-degree relative or a sibling who is/was affected by this condition, you would probably have it too.
Neurotransmitters: Mood swing disorder is caused by an imbalance in brain chemicals known as  neurotransmitters .
Treatment Methods:

Initial Treatment: The initial treatment method is to take medications to balance and control the mood swings. After the symptoms are in control, one has to start working with his/her trusted doctor for chalking out an effective and practical long-term treatment procedure.

Recovery from substance abuse: Problems related to excessive alcohol and drug abuse are solved by this therapy. Failing this step, this disorder can be unmanageable.

Day care treatment: Day care treatment programs can be recommended by your doctor. This treatment method includes counseling and support which keep the bipolar traits under control.

Hospitalization: Hospitalization or immediate medical support is recommended in case of suicidal thoughts or when a person starts exhibiting erratic behavior (being psychotic).

Medications: Medications include the administration of antipsychotics (such as ziprasidone, olanzapine), antidepressants (usually in combination with a mood stabilizer or an anti-psychotic), mood stabilizers (such as valproic acid, lithium, divalproex sodium) and anti-anxiety medications.

Bipolar Affective Disorder - Symptoms and Treatments

Ayurveda is a renowned life science that has been credited with changing lives since ancient times. Not only can it prevent diseases and ailments, but it can also cure them with its combination of herbal medication, everyday routine and yogic poses. Weight management is a field that also enjoys various Ayurvedic remedies. Some of them are as follows.

Herbs: Herbs are a way of healing used by Ayurveda, and the use of various herbs can help in hastening the metabolism for healthy weight management.

Taste: Ayurveda recognizes six distinct tastes that should be incorporated into one's daily diet. These tastes include salty, pungent, sour, sweet, bitter and finally, astringent. Each of these tastes has several properties that balance the various hormones and health factors in one's body. These tastes form the various counterpoints to alleviate all kinds of health problems, which finally help in effective weight management. Also, one must eat all the seasonal fruits and vegetables to keep the body and hormones in good balance.
 
Exercise: While a daily routine of exercise is a must in any life science, Ayurveda too propagates the devotion of at least 45 minutes to one hour towards some form of exercise. Walking is said to be the most important and effective forms of exercise, followed by several yoga poses that can help in better weight management. Also, as per Ayurveda, it is important to move after each and every meal, so that a routine of eating and activity is built into the system. 

Sleep: Ayurveda recognizes sleep or rest as one of the most important aspects of a healthy lifestyle. While good eating habits and exercise form one side of it, sleep or rest completes the triangle. One can also practice the Savasana or resting pose for a period of rest. And at least six to seven hours of sleep is a must as per Ayurveda.

Meditation: This practice helps in focusing on awareness which can instil the desired function like weight management in the body. Being mindful of what your body needs can also help in eating and exercising right.

Weight management is a lifelong process in Ayurveda.

Weight Management and Ayurveda

The risk of developing depression is found by the means of various researches to be two to three times higher in individuals suffering from a chronic disease than in normal individuals. Type 1 and type 2 Diabetes are chronic diseases that can prove to be very challenging to manage due to various setbacks and complications that can come in the way. Regular monitoring of the blood sugar levels is essential in managing the blood sugar. Navigation of the health care facilities, side effects caused by medications, and other related health conditions or even diabetic complications can cause an increased risk of developing depression. If left undiagnosed and untreated, depression can give way to a poor lifestyle choice that can further deteriorate the physical health of a person. 

Various risk factors that are associated with diabetes and depression are as follows- 

lack of physical activity
poor social environment
poverty
stress during pregnancy
Depression in diabetes can occur simultaneously due to a variety of factors. These include the psychological and psychosocial impact of the disease on an individual, a potential common genetic susceptibility and certain common pathophysiological abnormalities that involve neuro-immunological and neuro-endocrinal pathways, as well as microvascular brain lesions due to diabetes mellitus. However, issues concerning pathogenesis and causality of this high co-occurrence are not fully determined yet. Still, the presence of depression in patients with diabetes mellitus is of vast importance, as it is usually associated with poor disease control, adverse health outcomes and quality of life impairment.

When an individual is suffering from diabetes, the awareness of risks of developing depression is essential. It has been widely researched and found that these two conditions can occur simultaneously, where depression is usually undiagnosed. Diabetes, specifically type 2, and depression affect each other in a bi-directional manner, which means that each of the disease can prove as a risk factor for the other. In a state of depression, it is common for a person to consume high calorie foods and also to lead a sedentary lifestyle. This tendency can prove to be a risk factor for developing type 2 diabetes. 

If an individual already has type 2 diabetes, the stress experienced during the management of disease can cause depression. Type 1 diabetes develops as result of the defect of pancreas in production of insulin. 

People with type 1 diabetes can also develop depressive symptoms due to difficulties in the management of the disease. If the symptoms of depression develop in the patient already suffering from diabetes, management of diabetes also becomes difficult. This can lead to cause various diabetes related complications and also decrease the life expectancy. 

Various signs that can be observed in a state of depression are as follows: 

Complete lack of interest in doing any activity
Irritation or mood swings
Depressed mood
Disturbed sleep pattern
Changes in the appetite
Constant feeling of despair
Guilt Fatigue, weakness
Difficulty in concentration, transient memory loss
Suicidal tendency
There is a certain risk observed between the consumption of antidepressant medicines and development of diabetes. It has been researched and concluded that consuming antidepressants should always be on physician recommendation, with a prior advice on the risks of developing diabetes. It has also been found that the people with type 2 diabetes, who are using insulin regularly, are at higher risk for developing depression as compared to the people on non-insulin medications or following only diet or lifestyle modification habits. An additional stress experienced in managing diabetes and accessing the health care services can cause such complication in insulin users. 

Common treatment protocol for depression includes psychotherapy or the cognitive behavioral therapy. It helps people to correct destructive thought patterns and behaviors that tend to increase the depressive symptoms. Other interventions like a structured problem solving approach, motivational interviewing, and interpersonal approach towards the patient is also effective in management. Certain medications can also help in mood-lifting and the management of symptoms of depression.

In diabetics, the treatment options that are available in addition to the standard medical healthcare provision includes self-management training sessions that help the people to increase healthy habits and improve control on their blood sugar levels. Diabetes as well as depression can improve with complete focus on lifestyle changes, like proper diet management and exercising regularly.

How Diabetes Can Lead To Depression?

Just as children grow at different speeds, they respond to a speech therapist at different paces. Some children may need only one or two classes to master a sound, while others may need much longer. Some of the ways to make working with a speech therapist more productive are:

Have Clear Goals: When a speech therapist enters your family, the parents, therapist and child should have the same goals. Therapy would not help if the parents and therapists wanted to focus on different things. For example, the parents might be concerned with the child s vocabulary while the therapist may want to focus on articulations. Similarly, if the child does not understand the goal, he or she may not show much improvement. Ideally, a goal should be clear, measurable, realistic and be associated with a time frame. It should also be challenging but not out of reach.
Homework: A therapist has a limited amount of time to spend with the child. A majority of this time must be spent in learning something new each session. However, this will not be possible unless the child has made progress since the last class. Hence, it becomes important for the therapist to give the child homework and for the parents to oversee this. Video tutorials can be very helpful here. This helps parents know exactly what the child is supposed to practise.
Trust: A speech therapist may be an outsider to the family but he or she must be trusted to do their job in the way they think best. Very often, parents and therapists may not have the same views about how the child should be taught. Here, it is important to remember that the therapist is the expert and knows what he or she is doing. This is another reason why it is important to set clear goals together at the onset of therapy.
Speak Up: While the therapist may be an expert on how to build vocabulary and improve speech patterns, parents are experts on their child. Thus, it is important to communicate openly with the therapist. Answering therapist questions honestly can help him or her assess where the problem lies and in turn address it. Similarly, if you have questions, do not be afraid to speak to your therapist about them. Share the child s progress and changes that you have noted so that the therapist can adjust the lessons accordingly. 

Tips To Make The Speech Therapy More Effective!

Humans are social animals who thrive on reciprocality. It is in our basic nature to be socially courteous, and the word 'No' feels like a conflict that warns a potential relationship. Many of us tend to comply with every single request that is put forward to us by our peers, family, or at the workplace by our superiors. We choose to take up more jobs than we can efficiently handle and put unnecessary stress on ourselves even at the cost of our time and well-being. Must we always do that? 

Why is it so hard to say 'No'?

People have the notion that saying 'No' can come across as rude or uncaring. You may feel that you are letting someone down by turning down their request or risking a relationship. But, it has mostly to do with your self-confidence than your relationships with people. It may branch from overbearing parents, high expectations set by your peers and mentors or experiencing parenthood yourself and setting unreasonable standards for yourself. Childhood influences are usually the biggest cause of people always saying  yes  all the time.

People who have low self-confidence tend to value their own needs less than the needs of others. Saying 'No' feels rude, and no one wants to be impolite.

Well... saying 'No' does not mean you are being rude or disagreeable.

At the end of the day, it is more about how you say 'no', rather than just saying the word 'No'. Saying 'No' is about valuing and respecting your own time and priorities. 

How to start saying say 'No'?
If you want to take a step back and start saying 'No' to make sure your own needs are valued, here s what you need to do.

Refuse politely, when it seems not possible: Do not overcomplicate responses and try to be as simple in your responses as you can be. If you are asked to do something, and you want to say 'no', try to be polite in your body language and state that it is not convenient for you at the moment and that you would rather get back to it later.
Seek time before committing: The transition from saying  yes  all the time to saying no does take time! Start to give yourself more time and ask people to get back to you later. This way you can begin to build more self-confidence and learn to say no over time. This also allows you to evaluate your response instead of immediately saying yes or no to the person asking the favor or task.
Do not feel guilty: Deep down if you want to do a favor, you can go ahead with it, but you should also understand that it is okay to say no, and there is no need to associate guilt with it. You should set boundaries and allow people around you to understand how much favors they can ask you for instead of presenting you with an endless amount of favors from you.
Set your boundaries: Refusal does not amount to rejection as you have just as much right to say  no  as the person who is asking the favor from you. You are simply turning down a request, and in most situations, there is a middle ground for compromises where both you and the requester can be satisfied. If you have limited time to fulfill a request, let the person know and help out only as much as you can without overstepping your boundaries.
Bringing in these changes can help you be more self-confident, and at the same time enable you to say no when you need to without weighing yourself down with expectations and fear or rejection.

Simple Steps To Help You Say No!

Depression is often equated with isolation and brooding but this is not always the case. Many people may actually suffer from depression without showing the typical symptoms of this condition. Hence, this form of depression may go unnoticed for many years. Such cases are known as high-functioning depression. Some of the symptoms of this condition include:

Having difficulty expressing happiness: Though a person may be able to work normally, a person suffering from high-functioning depression will find it difficult to express emotions such as happiness. Thus he or she may not know how to act in the event of a promotion at work, the beginning of a new relationship or any other such happy events. In such cases, the happiness a person experiences from these events is temporary and muted.
Lowered energy levels: Unlike not being able to get out of bed when suffering from typical forms of depression, a person suffering from high-functioning depression can follow his or her usual routine. However, they often find themselves lacking the energy they would normally have and feel the need to put extra effort into their normal tasks. This reduces the amount of satisfaction derived from completing tasks.
Persistent self-doubt: While being self-critical is good to a certain extent, a person suffering from this form of depression is rarely satisfied with their work. Even when recognised by their peers or given an award for their work, they feel that this praise is misguided and have trouble accepting it. Thus, suffering from this condition is akin to swimming a race against the current and with additional unnecessary weights.
Substance abuse: Since this form of depression can go undiagnosed for many years, patients often turn to alcohol and other addictive substances in frustration. This can further delay diagnosis as many of the symptoms of this condition can also be attributed to substance abuse.
Feeling like a failure: Many people suffering from this condition feel as though they are constantly wasting time no matter how much they achieve in a day. This can make them feel hopeless and cause frequent changes in jobs.
The good news is that depression can be cured. Hence if someone around you or you, yourself experience such symptoms, talk to a doctor. Alternatively, you could make a few changes in your lifestyle to lift your mood. Try meditating in the morning or fit in some light exercise into your day. You could even take up a new hobby. However, this cannot replace cognitive therapy and psychological counselling.

High Functioning Depression & Anxiety!

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